Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrhythmia (List separately in addition to code for primary
CPT4 code
Name of the Procedure:
Intracardiac Catheter Ablation of a Discrete Mechanism of Arrhythmia (distinct from primary ablated mechanism)
Summary
Intracardiac catheter ablation involves threading a thin, flexible tube (catheter) into the heart to destroy (ablate) the abnormal tissue causing arrhythmia. This specific procedure focuses on treating an additional arrhythmia that is separate from the primary one already treated, possibly requiring repeat diagnostic maneuvers to confirm the target areas.
Purpose
The procedure addresses irregular heartbeats (arrhythmias). The goal is to correct the heart's rhythm by destroying small amounts of heart tissue that cause abnormal electrical signals.
Indications
- Persistent arrhythmias not controlled by medication
- Multiple arrhythmic focal points
- Failed previous ablation procedures
- Symptomatic tachycardias (rapid heartbeat)
- Conditions like Atrial Fibrillation or Supraventricular Tachycardia
Preparation
- Fasting for 6-8 hours before the procedure
- Adjusting or stopping certain medications
- Pre-procedure tests such as ECG, blood tests, and imaging studies
- Ensuring an IV line is in place for medication administration
Procedure Description
- The patient is given local anesthesia and possibly sedation.
- A catheter is inserted into a blood vessel in the groin, neck, or arm and guided to the heart.
- Electrodes on the catheter map the heart’s electrical activity.
- Repeat diagnostic maneuvers are performed to identify the distinct arrhythmic mechanism.
- Once located, the catheter delivers energy (radiofrequency or cryotherapy) to destroy the abnormal tissue.
- The procedure treats the additional arrhythmia distinct from the primary ablated mechanism.
Duration
Typically takes 2-6 hours, depending on complexity.
Setting
Performed in a hospital electrophysiology lab or specialized cardiac catheterization lab.
Personnel
- Cardiologist specialized in electrophysiology
- Electrophysiology technicians
- Nurses
- Anesthesiologist or sedation nurse
Risks and Complications
- Bleeding, infection, or bruising at catheter insertion site
- Heart perforation or damage
- Blood clots leading to stroke or heart attack
- Arrhythmia recurrence
- Rarely, need for a pacemaker
Benefits
- Alleviation of symptoms related to arrhythmia
- Reduced need for anti-arrhythmic medications
- Improved heart function and quality of life
- Immediate benefits in normalizing heart rhythm
Recovery
- Monitoring in hospital for several hours post-procedure
- Instructions to avoid strenuous activity for a few days
- Medication to prevent blood clots, as prescribed
- Follow-up appointments for ECG monitoring
Alternatives
- Anti-arrhythmic medications
- Electrical cardioversion
- Implantable devices like pacemakers or defibrillators
- Surgical options like Maze procedure
Patient Experience
- Minimal discomfort due to sedation/local anesthesia
- Sensations of pressure during catheter insertion
- Post-procedure tenderness at the insertion site
- Likely tiredness or mild pain relieved by prescribed medications